- CMS: Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
- Public Inspection: CMS: Medicare Program: Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction Model
- CMS: Secretarial Comments on the CBE's (Battelle Memorial Institute) 2024 Activities: Report to Congress and the Secretary of the Department of Health and Human Services
- HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- HRSA Announces Action to Lower Out-of-Pocket Costs for Life-Saving Medications at Health Centers Nationwide
- Public Inspection: HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Increased Risk of Cyber Threats Against Healthcare and Public Health Sector
- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization Program
- Announcing the 2030 Census Disclosure Avoidance Research Program
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- CMS: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
Funding Available for Pennsylvania Businesses that Maintained Access to Fresh, Healthy Foods During Pandemic
The Pennsylvania Department of Agriculture announced that the The Fresh Food Financing Initiative COVID-19 Relief Fund — funded through the CARES Act — is available to for-profit, nonprofit, or cooperative entities impacted by COVID-19, including grocery stores, corner stores, convenience stores, neighborhood markets, bodegas, food hubs, mobile markets, farmers markets, on-farm markets, urban farms, and food aggregation centers with a direct connection to direct-to-consumer retail outlets.
To be eligible, more than 50 percent of sales must be from staple and perishable foods to consumers and the retailer must serve customers that live in a low-to-moderate income area. Applicants must also provide access to affordable, high-quality fresh produce, meat and dairy products and other healthy grocery items for low-to-moderate income shoppers, and must accept SNAP and WIC to the maximum extent possible.
In recognition of the disproportionate impacts of both COVID-19 and food apartheid on communities made up of Black, Indigenous, and People of Color (BIPOC), and especially Black and African American communities, prioritization will be given to businesses owned by minorities and serving low-income BIPOC communities. Additional prioritization criteria include businesses located in or serving a USDA-designated food desert; businesses sourcing and selling Pennsylvania grown or processed products to the extent practicable; and applicants with supplier diversity and offering increased business opportunities for Minority Business Enterprises, Women Business Enterprises, Service-Disabled Veteran Business Enterprises, Veteran Business Enterprises, Lesbian, Gay, Bisexual, and Transgender Business Enterprises; and Disability-Owned Business Enterprises.
“This pandemic has revealed many things, one of the most prevalent has been about where our food comes from – how it gets from the farm to those who need it. This relief fund is about strengthening the local food system and improving food security and nutrition,” said Sec. Redding. “We need to stimulate local economies, increase market opportunities for Pennsylvania farmers, create jobs, and contribute to better health by improving access to fresh, local foods – we need to feed Pennsylvania, now and in the years to come. And that is all a part of this initiative.”
The program is administered by the Department of Agriculture in partnership with the Department of Community and Economic Development. Applications will be accepted through August 14, 2020. Grant funds will be distributed to eligible applicants for impacts related to COVID-19 that have been incurred between March 1, 2020 and November 30, 2020, such as:
- Higher operating costs related to cleaning and social distancing requirements, including costs related to outside contracting associated with managing social distancing, limited occupancy, and cleaning;
- Infrastructure improvements including renovation, new construction, or adaptive reuse directly related to COVID-19;
- Equipment purchases that improve the availability of quality fresh food, such as additional refrigeration to manage volume, or personal protective equipment such as plexiglass dividers;
- Inventory (higher cost of goods, higher transportation or delivery costs, or procuring Pennsylvania-grown produce, meat, and dairy products, or loss of product);
- Innovative food access technology such as mobile or pop-up markets, or mobile EBT reader technology;
- Costs to expand access to Pennsylvania grown or processed produce, dairy and meat products or provide stable market access for Pennsylvania farmers that have lost or limited markets; and
- Other one-time or increased expenses incurred related to COVID-19.
“The COVID-19 pandemic has highlighted the individuals and businesses that stepped up to protect and provide for their communities over the past several months, by supplying critical goods and services,” said Sec. Davin. “Little is as life sustaining as providing access to fresh, healthy food, especially in food-insecure areas. This funding will help alleviate the financial burdens placed on Pennsylvania’s food system during the pandemic and will ensure continued access to nutritional foods as we work toward greater recovery.”
The Pennsylvania Department of Agriculture (department) will accept applications until August 14, 2020. If you have any questions about the application process or need an application sent to you via mail, please email Michael Roth at michroth@pa.gov.
To apply for funding, the applicant must submit the on-line Electronic Single Application for Assistance located at www.esa.dced.state.pa.us. In addition to the Electronic Single Application for Assistance, the applicant should provide the following items when applying for the grant. All items should be attached electronically to the ESA submission. Awarded grants are reimbursement grants, so applicants are responsible to spend all funds prior to submitting for reimbursement.
For full details on Fresh Food Financing Initiative COVID-19 Relief Fund eligibility, award amounts, additional prioritizations, and criteria visit agriculture.pa.gov/foodsecurity.
For information as it relates to agriculture during COVID-19 mitigation in Pennsylvania visit agriculture.pa.gov/COVID. For the most accurate, timely information related to Health in Pennsylvania, visit on.pa.gov/coronavirus.
Journal of Appalachian Health Is Now On the Directory of Open Access Journals!
The Journal of Appalachian Health has been added to the Directory of Open Access Journals.
DOAJ is a community-curated online directory that indexes and provides access to high quality, open access, peer-reviewed journals. DOAJ is independent; All funding is via donations. All DOAJ services are free of charge including being indexed in DOAJ. All data is freely available.
DOAJ operates an education and outreach program across the globe, focusing on improving the quality of applications submitted (Source: DOAJ, 2020).
Clarification on RHC and FQHC Cost Sharing Announced
On July 6, CMS updated MLN Matters Article SE20016 to clarify how Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can apply the Cost Sharing (CS) modifier to preventive services furnished via telehealth. This update includes:
- Additional claim examples
- New section on the RHC Productivity Standard
COVID-19 Crisis Fire Company and EMS Grant Program Funding Available in Pennsylvania
The Pennsylvania Emergency Health Services Council has announced that COVID-19 Crisis Fire Company and EMS Grant Program funding is now available. Organizations are urged to access the following links to check eligibility and for application details.
https://www.osfc.pa.gov/GrantsandLoans/Pages/COVID-19-Fire-Rescue-EMS-Grant.aspx?fbclid=IwAR0C9oOMttwYWykLir2_qPHMLvsVY4js7awH8grFZbqJds4HiZNAmtZMMa8
Providers Urged to Submit Data by July 20 Deadline for Medicaid and CHIP Relief Funds
HHS recently announced the additional distributions from the Provider Relief Fund to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs. HHS expects to distribute approximately $15 billion to eligible providers that participate in state Medicaid and CHIP programs and have not received a payment from the Provider Relief Fund General Distribution. Eligible providers must submit their data by July 20.
Before applying through the Enhanced Provider Relief Fund Payment Portal, applicants can watch a webinar about the application process for Medicaid/CHIP providers. An additional webinar is scheduled for Wednesday, July 8 at 4:00 pm EDT, which you can register for here. I also encourage you to review the most recent FAQs on the program and the Medicaid/CHIP targeted distribution here.
More Research Points to Importance of Masks, Mandatory Mask-Wearing Order Remains in Effect
Pennsylvania Governor Wolf’s Administration highlighted recent research studies that further point to the importance of wearing masks to stop the spread of COVID-19.
According to a recent, comprehensive study published in The Lancet and funded by the World Health Organization, which identified 172 observational studies across 16 countries and six continents, face mask use could result in a large reduction in risk of infection from COVID-19, in particular when combined with social distancing.
A study by a team of researchers led by a Texas A&M University professor has found that not wearing a face mask dramatically increases a person’s chances of being infected by the COVID-19 virus. The findings were published in the PNAS (Proceedings of the National Academy of Sciences). According to the study’s findings, “not wearing a face mask dramatically increases a person’s chances of being infected by the COVID-19 virus.”
And a recent modeling study by the Royal Society A notes that wearing masks in public could have a major impact toward reducing the spread of COVID-19. According to the modeling, “Under certain conditions, when lock-down periods are implemented in combination with 100% facemask use, there is vastly less disease spread, secondary and tertiary waves are flattened, and the epidemic is brought under control. The effect occurs even when it is assumed that facemasks are only 50% effective at capturing exhaled virus inoculum with an equal or lower efficiency on inhalation.”
Pennsylvania Secretary of Health Dr. Rachel Levine signed an order mandating mask-wearing on July 1. It remains in effect. Frequently Asked Questions about the mask-wearing order can be found here.
Rural Health Network Development Planning Program Recipients Announced
The Federal Office of Rural Health Policy (FORHP) awarded approximately $2 million to twenty awardees for the 2020 Rural Health Network Development Planning (Network Planning) Program.
The Network Planning program, administered by HRSA’s Federal Office of Rural Health Policy (FORHP) focuses on the planning and development of integrated health care networks, specifically network participants who do not have a history of formal collaborative efforts in order to (i) achieve efficiencies; (ii) expand access to, coordinate, and improve the quality of essential health care services; and (iii) strengthen the rural health care system as a whole. The intent is that rural health networks will expand access to care, increase the use of health information technology, explore alternative health care delivery models, and continue to achieve quality health care across the continuum of care from prevention and wellness, to acute and long-term care.
Recipients from 15 states received up to $100,000 for a one-year project period that will focus on building, strengthening, and formalizing integrated health care networks and systems, developing training cooperatives, conducting community health needs assessments, increasing service capacity, addressing behavioral health conditions, and addressing the opioid epidemic. You can view the list of awardees here.
With FORHP support, these organizations will work towards becoming operational and sustainable beyond the one-year project period, achieving long-term outcomes such as increasing their focus on showing value in health care delivery creates incentives to develop regional systems of care that preserve local autonomy for rural communities while also ensuring access to the appropriate continuum of care for the local service population. These funded organizations are helping to change how health care is being delivered in rural communities.
Pennsylvania BLS Ambulance Staffing Exceptions Bulletin Published
Act 17 of 2020 amended the EMS System Act to permit the Department of Health to grant exceptions to the ambulance staffing standard for Basic Life Support (BLS) ambulances for agencies not licensed to provide service higher than the BLS level. The Bureau of EMS has established a process and criteria for accepting and reviewing these exception requests from EMS agencies.
The BLS Ambulance Staffing Exceptions Bulletin from the Pennsylvania Department of Health can be accessed below.
EMSIB 2020-27 Act 17 of 2020 BLS Ambulance StaffingExceptions
Pennsylvania Hospital Transitions HRSA-Funded Program to Online Services and Addresses COVID-19 Stress
by Allee Mead
Butler Memorial Hospital in Pennsylvania received a HRSA Rural Health Care Services Outreach grant to develop a program for chronic disease patients. Partway through the grant cycle, the COVID-19 pandemic hit. The hospital shares how it was able to transition its program services to an online format and develop new initiatives to address stress in the healthcare workforce and the larger community.
Access the full article here.
CMS COVID-19 Stakeholder Engagement Calls – July
CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.
Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. These calls are not intended for the press.
Calls recordings and transcripts are posted on the CMS podcast page at: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts
CMS COVID-19 Office Hours Calls (Tuesdays at 5:00 – 6:00 PM Eastern)
Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:
- Increase Hospital Capacity – CMS Hospitals Without Walls;
- Rapidly Expand the Healthcare Workforce;
- Put Patients Over Paperwork; and
- Further Promote Telehealth in Medicare
This week’s Office Hours:
Tuesday, July 7th at 5:00 – 6:00 PM Eastern
Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 3048844
Additional Office Hours:
Tuesday, July 14th at 5:00 – 6:00 PM Eastern
Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 2550919
Tuesday, July 21st at 5:00 – 6:00 PM Eastern
Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 7477995
Tuesday, July 28th at 5:00 – 6:00 PM Eastern
Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 1492795
Weekly COVID-19 Care Site-Specific Calls
CMS hosts weekly calls for certain types of organizations to provide targeted updates on the agency’s latest COVID-19 guidance. One to two leaders in the field also share best practices with their peers. There is an opportunity to ask questions of presenters if time allows.
Home Health and Hospice (twice a month on Tuesday at 3:00 PM Eastern)
Tuesday, July 7th at 3:00 – 3:30 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 9480618
Tuesday, July 21st at 3:00 – 3:30 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 6080197
Nursing Homes (twice a month on Wednesday at 4:30 PM Eastern)
Wednesday, July 8th at 4:30 – 5:00 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 2997138
Wednesday, July 22nd at 4:30 – 5:00 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 1143564
Dialysis Organizations (twice a month on Wednesday at 5:30 PM Eastern)
Wednesday, July 8th at 5:30 – 6:00 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 8481378
Wednesday, July 22nd at 5:30 – 6:00 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7692208
Nurses (twice a month on Thursdays at 3:00 PM Eastern)
Thursday, July 9th at 3:00 – 3:30 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 9386539
Thursday, July 23rd at 3:00 – 3:30 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7971869
Lessons from the Front Lines: COVID-19 (twice a month on Fridays at 12:30 – 2:00 PM Eastern)
Lessons from the Front Lines calls are a joint effort between CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians are invited to share their experience, ideas, strategies, and insights with one another related to their COVID-19 response. There is an opportunity to ask questions of presenters.
Next Lessons from the Front Lines:
Friday, July 17th at 12:30 – 2:00 PM Eastern
Toll Free Attendee Dial-In: 833-614-0820; Access Code: 3096434
To keep up with the important work the White House Task Force is doing in response to COVID-19 click here: https://protect2.fireeye.com/url?k=50c582c2-0c908b12-50c5b3fd-0cc47a6a52de-d2b3787f2fc1a6db&u=https://protect2.fireeye.com/url?k=1c9266c7-40c76fd4-1c9257f8-0cc47adb5650-f1f55d7f990cafab&u=https://protect2.fireeye.com/url?k=36fa2226-6aae0b0d-36fa1319-0cc47a6d17cc-2d06c219f858d641&u=http://www.coronavirus.gov/.
For information specific to CMS, please visit the Current Emergencies Website.